title: Relation between degree of weight loss after bariatric surgery and reduction in albuminuria and C-reactive protein.
abstract: BACKGROUND
  Bariatric surgery achieves long-term weight loss in obese adults with amelioration of diabetes and hypertension. Improvement in albuminuria and high-sensitivity C-reactive protein (hs-CRP) has also been reported. We investigated, at a weight control center in a community hospital setting, the relation between degree of surgical weight loss and reduction in the cardiovascular risk markers, albuminuria and hs-CRP.
  
  
  METHODS
  We performed a retrospective study of 62 obese adults who had undergone Roux-en-Y gastric bypass surgery and had a median follow-up of 15 months.
  
  
  RESULTS
  The baseline (preoperative) mean age was 46 years, 82% were women, 26 had a blood pressure of > or =140/90 mm Hg, and 25 had type 2 diabetes. During follow-up (postoperative), a decrease occurred in the body mass index (mean +/- standard deviation 49.2 +/- 8.7 kg/m(2) to 34.1 +/- 8.1 kg/m(2); P <.0001), excess body weight (mean +/- SD 76.1 +/- 23.6 kg to 34.9 +/- 21.7 kg; P <.0001), hemoglobin A1c (mean +/- SD 6.5% +/- 1.3% to 5.6% +/- 0.8%; P <.0001), systolic blood pressure (mean +/- SD 133.7 +/- 14.3 mm Hg to 112.9 +/- 14.6 mm Hg; P < .0001), urine albumin creatinine ratio (from a median of 8.0 mg/g [interquartile range 5.0-29.3] to a median of 6.0 mg/g [interquartile range 3.3-11.5]; P <.0001), and hs-CRP (mean +/- SD 11.2 +/- 9.8 mg/L to 4.7 +/- 5.9 mg/L; P <.0001). The study sample was divided into tertiles of the percentage of excess body weight loss; the mean percentage of excess body weight loss was -37.1% +/- 5.5% in the first tertile, -54.3% +/- 6.8% in the second tertile, and -75.8% +/- 10.9% in the third tertile. The median percentage of change in albuminuria was greatest (median -52.8%, interquartile range -79.1% to -17.5%) in the third tertile, intermediate (median -45.5%, interquartile range -72.4% to 0%) in the second tertile, and lowest (-42.6%, interquartile range -80.5% to 16.7%) in the first tertile (P = .953). The mean percentage of change in hs-CRP was greatest (-72.4% +/- 30.4%) in the third tertile, intermediate (-55.4% +/- 31.9%) in the second tertile, and lowest (-44.8% +/- 30.6%) in the first tertile (P = .037).
  
  
  CONCLUSIONS
  The results of our study have shown that obese adults experience a reduction in albuminuria and hs-CRP after bariatric surgery, with a greater reduction in hs-CRP observed with more surgical weight loss.
authors.affiliation: Department of Medicine, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. varunagrawal1996@yahoo.com
authors.forename: Varun
authors.initials: V
authors.lastname: Agrawal
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krause
authors.forename: David L
authors.initials: DL
authors.lastname: Chengelis
authors.forename: Kerstyn C
authors.initials: KC
authors.lastname: Zalesin
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Rocher
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000517:prevention & control*; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism*; D016009:Chi-Square Distribution; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D002097:C-Reactive Protein